低危非肌层浸润性膀胱癌术后即刻膀胱灌注与维持膀胱灌注的疗效对比

Efficacy comparison of immediate bladder irrigation versus maintenance bladder irrigation after surgery for low-risk non-muscle-invasive bladder cancer

目的分析低危非肌层浸润性膀胱癌(NMIBC)术后患者分别采用即刻膀胱灌注与维持膀胱灌注吡柔比星(THP)的方式进行治疗的效果及不良反应发生情况。方法60例低危NMIBC患者,随机分为观察组和对照组,每组30例。两组患者均接受经尿道膀胱肿瘤电切术(TURBT),观察组患者术后采用即刻灌注,对照组患者术后采用维持灌注。随访至术后1年,比较两组患者血清血管内皮生长因子(VEGF)、成纤维细胞生长因子(FGF)、可溶性细胞间粘附分子-1(sICAM-1)水平及术后复发率、不良反应发生情况。结果术后1年,观察组患者血清VEGF、FGF、sICAM-1水平分别为(32.23±4.12)ng/ml、(14.68±1.34)pg/L、(97.12±8.35)ng/L,对照组患者分别为(31.11±5.42)ng/ml、(13.67±2.46)pg/L、(95.33±12.42)ng/L,比较差异无统计学意义(P>0.05)。观察组患者复发率为13.33%,对照组为10.00%,比较差异无统计学意义(P>0.05)。观察组患者不良反应发生率为6.67%,显著低于对照组的26.67%,差异有统计学意义(P<0.05)。结论低危NMIBC术后即刻膀胱灌注的肿瘤标注物水平、肿瘤复发率与维持膀胱灌注无显著差异,同时不良反应较少,可以减少患者治疗的痛苦和经济负担,具有较高的临床应用价值。

Objective To analyze the effect and occurrence of adverse reactions of treatment with immediate bladder irrigation versus maintenance bladder irrigation with piroplatin(THP)in patients with lowrisk non-muscle invasive bladder cancer(NMIBC)after surgery.Methods A total of 60 patients with low-risk NMIBC were randomly divided into an observation group and a control group,with 30 patients in each group.Patients in both groups underwent transurethral resection of bladder tumor(TURBT),with immediate irrigation in the observation group and maintenance irrigation in the control group.The patients were followed up to 1 year after surgery,the serum levels of vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),soluble intercellular adhesion molecule-1(sICAM-1),postoperative recurrence rate,and occurrence of adverse reactions were compared between the two groups.Results At 1 year after surgery,the serum levels of VEGF,FGF,and sICAM-1 were(32.23±4.12)ng/ml,(14.68±1.34)pg/L,and(97.12±8.35)ng/L in the observation group,and(31.11±5.42)ng/ml,(13.67±2.46)pg/L,and(95.33±12.42)ng/L in the control group.The differences were not statistically significant between the two groups(P>0.05).The recurrence rate was 13.33%in the observation group and 10.00%in the control group,and the difference was not statistically significant(P>0.05).The incidence of adverse reactions was 6.67%in the observation group,which was significantly lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion The level of tumor markers and tumor recurrence rate of immediate bladder irrigation in low-risk NMIBC are not significantly different from that of maintenance bladder irrigation,while the adverse reactions are less,which can reduce the pain and economic burden of patients and have high clinical application value.